Quality Assurance Specialist
About The Position
The Quality Assurance Specialist oversees various areas of billing and documentation for compliance to contractual obligations with various mandates and State laws, rules, regulations, sub-contractual agreements, HIIPA, Medicaid, agency policy and procedures to provide training and feedback to service delivery staff on areas of needed correction/ improvement. Additionally, the Quality Assurance Specialist will work collaboratively with supervisors and management staff to ensure the accuracy and quality of client documentation, client services, records and documentation within the agency.
Requirements
- Must have computer skills, including spreadsheet, word processing and publishing programs
- Excellent written and verbal communication skills with good vocabulary, spelling, and proofreading skills
- Strong research skills
- Strong customer service and interpersonal skills
- Demonstrated ability to work independently and with limited supervision
- Demonstrated ability to coordinate multiple activities
- High School Diploma or GED
- Minimum 6 months experience in administrative support or clerical field
- Experience with Microsoft applications and basic computer programs
- Lived experience with addiction and be in recovery
Nice To Haves
- Prior experience in customer service
- Prior experience with AKAIMS electronic health records system
Responsibilities
- Responsible for the review and content compliance of all documentation submitted to the SUD client record, including, but not limited to: intake documents, assessments, client treatment plans, progress notes, change of diagnoses, outcome measures, collateral documents, and correspondence.
- Ensures that the “Golden Thread” of medical necessity is documented within the client record in accordance with TNR and State policy and procedures.
- Answer telephone inquiries and/or refer to appropriate staff, return messages
- Data Entry intake packet into AKAIMS
- Acquire service Authorization through the Medicaid site
- Enter in Authorization in AKAIMS
- Create paper and electronic records for all clients
- Maintain inactive files keeping them in proper order, shredding any unnecessary documents
- Assist program manager, specialists, and executive director in any proofreading, data entry, clerical work as requested
- Use general office equipment such as copy machines, printers, and facsimile machines
- Maintaining confidentially according to regulations and policy
- Perform all other duties as assigned
Benefits
- ICHRA Coverage for Employee
- 401K Plan - 100% Match Up To 5%
- Life & ADD Insurance Policy 100% covered by employer
- Vision and Dental Policy 90% covered by employer
- 10 Paid Holidays a Year
- Paid Time Off Accrual
- Paid Training and Credentialing
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
